AIDS Drugs Boost Heart Attack Risk
Still, 'Cocktail' Therapy Provides More Benefit to Those With HIV
Currier calls this new study important and well done. "It contributes to our understanding and thinking about this subject. Since the more potent treatments have only been available for seven or eight years, we don't know yet about their long-term effect. But people are doing very well on these drugs, and our estimate is that this benefit will continue."
In her own research, she finds that HIV-positive patients who take protease inhibitors for at least two years have no increase in artery thickness compared with those not taking these drugs. This increased artery thickness could signal atherosclerosis, a marker for heart disease.
Some previous studies, like this new one, suggest there's a small but measurable increased risk of heart attack from newer, more potent drugs. But another major finding, published last February in TheNew England Journal of Medicine and involving some 37,000 treated with AIDS cocktails and other drugs since 1993, concludes that the "fear of accelerated vascular diseaseneed not compromise antiretroviral therapy over the short-term."
"If you look at a large enough group of patients carefully enough, there is a suggestion there may be a modest but significant increase in cardiovascular risk," says Daniel R. Kuritzkes, MD, director of AIDS research at Brigham and Women's Hospital in Boston, who wrote an editorial to the February study. "But there is an enormous benefit from antiretroviral therapy."
He tells WebMD that since combination-drug AIDS cocktails have become available, the overall death rate from AIDS has decreased between 70% and 80%.
"In the grand scheme of things, where drugs that might cause (high cholesterol) are necessary, patients will get far greater benefit from them in terms of an effect on their HIV than from their downstream risk of heart disease."